Provider Demographics
NPI:1538055967
Name:GHAZALBA, LAYLA
Entity type:Individual
Prefix:
First Name:LAYLA
Middle Name:
Last Name:GHAZALBA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAYLA
Other - Middle Name:AMATULLAH VOOTS
Other - Last Name:GHAZALBA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2233 WILLAMETTE ST
Mailing Address - Street 2:BUILDING F
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405
Mailing Address - Country:US
Mailing Address - Phone:541-216-4034
Mailing Address - Fax:
Practice Address - Street 1:2233 WILLAMETTE ST
Practice Address - Street 2:BUILDING F
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405
Practice Address - Country:US
Practice Address - Phone:541-216-4034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-13
Last Update Date:2025-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health